Original Article

Early seizures after temporal lobectomy predict subsequent seizure recurrence

  1. Anne M. McIntosh PhD1,2,3,
  2. Renate M. Kalnins FRACP4,
  3. L. Anne Mitchell FRACR5,6,
  4. Samuel F. Berkovic MD1,3,7,*

Article first published online: 24 JAN 2005

DOI: 10.1002/ana.20372

Issue

Annals of Neurology

Annals of Neurology

Volume 57, Issue 2, pages 283–288, February 2005

Additional Information

How to Cite

McIntosh, A. M., Kalnins, R. M., Mitchell, L. A. and Berkovic, S. F. (2005), Early seizures after temporal lobectomy predict subsequent seizure recurrence. Annals of Neurology, 57: 283–288. doi: 10.1002/ana.20372

Author Information

  1. 1

    Epilepsy Research Centre, University of Melbourne

  2. 2

    School of Nursing, University of Melbourne

  3. 3

    Department of Medicine (Neurology), University of Melbourne

  4. 4

    Department of Anatomical Pathology, Austin Health, Melbourne, Victoria, Australia

  5. 5

    Department of Radiology, Austin Health, Melbourne, Victoria, Australia

  6. 6

    Department of Radiology, University of Melbourne

  7. 7

    Department of Neurology, Austin Health, Melbourne, Victoria, Australia

*Epilepsy Research Centre (Repatriation Campus) Austin Health, Melbourne, Victoria 3081, Australia

Publication History

  1. Issue published online: 24 JAN 2005
  2. Article first published online: 24 JAN 2005
  3. Manuscript Revised: 22 NOV 2004
  4. Manuscript Accepted: 22 NOV 2004
  5. Manuscript Received: 1 SEP 2004

Funded by

  • Australian National Health and Medical Research Council. Grant Number: 219280
  • Austin Hospital Medical Research Foundation
  • Epilepsy Association

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article (HTML) Get PDF (81K)

Abstract

Patients are understandably anxious if seizures occur immediately after temporal lobectomy. Such “neighborhood” seizures are commonly regarded as irrelevant to seizure outcome and discounted in outcome measurement. We conducted an in-depth examination of early postoperative seizures (<28 days) and outcome. The risk of recurrence at one postoperative year was calculated using Poisson regression, and statistical adjustments were made for preoperative pathology. Of 321 patients, 69 (22%) experienced early postoperative seizures. These early seizures were associated with subsequent seizure recurrence (rate ratio [RR] 5.9; 95% confidence interval [CI], 4.1–8.4). Among patients with early seizures, the only significant factor was the presence of seizure precipitants, which was associated with a lower recurrence risk. However, when compared with patients with no early seizures, those with precipitants to early seizures had a higher risk of recurrence (RR, 3.0; 95% CI, 1.8–5.2). The risk was higher again for patients without precipitants to early seizures (RR, 7.6; 95% CI, 5.0–11.5). Early seizures and other seizure recurrences in the first postoperative year did not differ in their effect on subsequent outcome (X2 [3] = 3.4, p = 0.33). We conclude that early postoperative seizures are associated with subsequent seizure recurrence. These findings have implications for patient counseling and the measurement of outcome. Ann Neurol 2005;57:283–288

View Full Article (HTML) Get PDF (81K)